{include file="public/header"/}
{include file="public/navleft"}

<div class="tpl-content-wrapper">
    <div class="tpl-content-page-title">
        项目增加
    </div>
    <ol class="am-breadcrumb">
        <li><a href="#" class="am-icon-home">首页</a></li>
        <li><a href="#">表单</a></li>
        <li class="am-active">项目详情 表单</li>
    </ol>
    <div class="tpl-portlet-components">
        <div class="portlet-title">
            <div class="caption font-green bold">
                <span class="am-icon-code"></span> 表单
            </div>
            <div class="tpl-portlet-input tpl-fz-ml">
                <div class="portlet-input input-small input-inline">
                    <div class="input-icon right">
                        <i class="am-icon-search"></i>
                        <input type="text" class="form-control form-control-solid" placeholder="搜索..."> </div>
                </div>
            </div>
        </div>
        <div class="tpl-block ">

            <div class="am-g tpl-amazeui-form">

                <div class="am-u-sm-12 am-u-md-9">

                    <form action="{:url('xmb/onekeyxmcopybyxmmc')}" class="am-form am-form-horizontal" method="post">

                        <div class="am-form-group am-form-success am-form-icon am-form-feedback">
                            <label class="am-u-sm-2 am-form-label" for="doc-ipt-3-a">新小项目名称：</label>
                            <div class="am-u-sm-10">
                                <input class="am-form-field" id="doc-ipt-3-a" name="newxmmc" placeholder="" type="text"
                                       value="">
                                <span class="am-icon-warning"></span>
                            </div>
                        </div>


                        <div class="am-form-group">
                            <label class="am-u-sm-2 am-form-label" for="doc-ipt-3-a">仪器平台:</label>
                            <div class="am-u-sm-10">

                                <select name="yqdh" lay-search>

                                    {volist name='data.yqdh' id='v'}
                                    <option value="{$v.yqdh}">{$v.yqdh}</option>
                                    {/volist}
                                    <option value="外包标本" selected>外包标本</option>
                                </select>
                            </div>
                        </div>


                        <div class="am-form-group">
                            <label class="am-u-sm-2 am-form-label" for="doc-ipt-3-a">委托单位:</label>
                            <div class="am-u-sm-10">
                                <select name="hosiptalname" lay-search>
                                   {volist name='data.outhospital' id='v'}
                                    <option value="{$v.hosiptalname}">{$v.id.':'.$v.hosiptalname}</option>
                                    {/volist}
                                    <option value="" ></option>
                                    <option value="杭州千麦" selected>杭州千麦</option>
                                </select>
                            </div>
                        </div>


                        <div class="am-form-group">
                            <label class="am-u-sm-2 am-form-label" for="doc-ipt-3-a">标本种类:</label>
                            <div class="am-u-sm-10">

                                <select name="bbzl"  lay-verify="" lay-search>

                                    {volist name='data.bbzl' id='v'}
                                    <option value="{$v.mc}">{$v.dh.':'.$v.mc}</option>
                                    {/volist}
                                    <option value="血清" selected>血清</option>
                                </select>
                            </div>
                        </div>

                        <div class="am-form-group am-form-success am-form-icon am-form-feedback">
                            <label class="am-u-sm-2 am-form-label" for="doc-ipt-3-a">新项目代号(默认自动添加)：</label>
                            <div class="am-u-sm-10">
                                <input class="am-form-field" id="doc-ipt-3-a" name="newxmdh" placeholder="" type="text"
                                       value="{$data.endXmdh}" readonly  unselectable="on" >
                                <span class="am-icon-warning"></span>
                            </div>
                        </div>

                        <div class="am-form-group am-form-success am-form-icon am-form-feedback">
                            <label class="am-u-sm-2 am-form-label" for="doc-ipt-3-a">新项目编号(默认自动添加)：</label>
                            <div class="am-u-sm-10">
                                <input class="am-form-field" id="doc-ipt-3-a" name="newxmbh" placeholder="" type="text"
                                       value="{$data.endXmbh}" readonly  unselectable="on">
                                <span class="am-icon-warning"></span>
                            </div>
                        </div>


                        <div class="am-form-group am-form-success am-form-icon am-form-feedback">
                            <label class="am-u-sm-2 am-form-label" for="doc-ipt-3-a">新项目检验目的(默认自动添加)：</label>
                            <div class="am-u-sm-10">
                                <input class="am-form-field" id="doc-ipt-3-a" name="newjymddm" placeholder="" type="text"
                                       value="{$data.endJymddh}" readonly  unselectable="on">
                                <span class="am-icon-warning"></span>
                            </div>
                        </div>

                        <div class="am-form-group">
                            <div class="am-u-sm-9 am-u-sm-push-6">
                                <button type="submit" class="am-btn am-btn-primary">增加单项检验目的</button>

                            </div>
                        </div>
                    </form>

                </div>
            </div>
        </div>
    </div>
</div>

</div>

</div>
</div>
{include file="public/footer"/}
</body>
</html>
